Three-dimensional analysis of models articulated in the seated condylar position from a deprogrammed asymptomatic population: a prospective study. Part 1.

INTRODUCTION

The seated condylar position (SCP), also known as centric relation (CR), is considered the most reliable and reproducible reference point for accurately recording the relationship of the mandible to the maxilla. Therefore, a determination of the SCP/CR is a prerequisite for the analyses of the dental interarch, condylar position, and skeletal relationships. The purpose of this prospective study was to statistically evaluate the 3-dimensional nature of dental interarch displacement and condylar displacement between the SCP/CR and maximum intercuspation or centric occlusion (MIC/CO).

METHODS

The records of 596 consecutive asymptomatic patients having routine orthodontic treatment in a private practice were used. The initial premature occlusal contact and 3-dimensional dental interarch displacement were measured by the analysis of models, mounted on an articulator (Panadent, Grand Terrrace, Calif) in the SCP/CR, by using the modified (nonmanipulated) 2-piece wax SCP/CR recording method with deprogramming. Three-dimensional condylar displacement was measured by analysis of the graphic registrations, produced by condylar position instrumentation, and evaluated for frequency, direction, and magnitude of displacement.

RESULTS

The dental interarch discrepancy in the SCP/CR was significantly different from that observed in MIC/CO, with posterior premature contacts (94.0%), increased overjet, decreased overbite, midline differences, and Angle classification changes. A difference in condylar position between the SCP/CR and MIC/CO in at least 1 plane was detected for every asymptomatic patient and every condyle. The most prevalent types of directional change in condylar position were inferior (down) (97.0%) and distal (posterior) (66.7%) when the teeth were brought into MIC/CO. The mean difference in condylar position between the SCP/CR and MIC/CO was .86 mm in the horizontal plane, 1.80 mm in the vertical plane, and .26 mm in the transverse plane. No correlation was found between a patient's age or sex and the magnitude of condylar displacement.

CONCLUSIONS

There is a significant difference in the occlusion when it is dictated by the teeth and when it is dictated by the condyles. This difference is quantifiable at both the occlusal and condylar levels.